They can snap off close-call medical emergency stories like cards from a deck, but the four gray-haired men lunching at Charley's Crab aren't playing cards. They're playing politics and telling stories. They figure their efforts could save the lives of the condo dwellers who populate the barrier island east of the Intracoastal Waterway in Fort Lauderdale. As presidents of sizable condominium kingdoms, the men at the table are also the harbingers of bad news. They predict that a few of their neighbors may die needlessly, starting in about 18 months.

To back up his claim, each community leader shares a personal story of midnight alarms or midday sprints to the only emergency room on the barrier island, the Cleveland Clinic.

Mark Hariton lives at Berkley South near his 83-year-old mother, who has taken the frantic ambulance ride to the clinic four times with her son by her side. She's doing just fine these days. Ray Wolowicz's wife made the ride only once when an aneurysm threatened her life. Ray was right there holding her hand all the way in the back of an ambulance. The couple flew past the high-rise condos facing the beach and slid into the slender drive marked "Emergency," just south of Oakland Park Boulevard. She remains alive and well these days, too.

Bob Rozema took the same gut-wrenching ride with his wife. But when Bob quietly suggested to EMS medics they travel to his doctor's resident hospital off the barrier island, the medics took one look at her and said no, faster is better, five or ten minutes could make a difference. The ambulance went straight south from the couple's condo on Galt Ocean Drive to the Clinic, sticking to A1A all the way. Bob's wife found herself in surgery minutes later and survived.

In every one of those cases and thousands more like them, nobody ever confronted an open drawbridge in the rush to reach a hospital or faced congested mainland traffic that can back up during rush hours.

Their good fortune will now change. For the first time in a quarter century, beach residents will no longer have speedy access to emergency services east of the bridges that connect them to the mainland. Cleveland Clinic owners say they will move their hospital to Weston in the summer of 2001, motivated by the ambition to expand and the potential big-bucks sale of their valuable property facing the beach.

After years of laissez-faire development allowed by city officials who relaxed codes restricting building size on the beach, prices for property there have shot up. They now range between $25 and $100 per square foot, according to realtors. The boom has created a market of which hospital officials will take advantage to pay for a medical campus of 500,000 square feet in Weston -- roughly the size of 160 four-bedroom homes.

Such progress and prosperity could kill somebody. Cleveland Clinic's departure will leave almost 30,000 beach residents and visitors to face a significantly longer ride to the nearest emergency room, which is Holy Cross Hospital at NE 47th Street and North Federal Highway. According to EMS officials, the ride will average five to ten minutes longer for most residents. If traffic is flowing. But ambulance rides off the island will inevitably face open drawbridges and traffic jams at some point in time. Any delay endangers lives, says Fort Lauderdale's EMS chief, Don DePetrillo.

More than a few lives, perhaps. About 300 people per month now arrive at the Cleveland Clinic emergency room in the back of EMS vehicles, roughly half of them stricken with life-threatening maladies. "What are you going to do when somebody has a heart attack during the boat parade, the bridges are up, and there's no emergency clinic here?" Hariton wonders. It's a question being asked by many who have already signed petitions distributed by the men seated around the table. Hariton and his corps of activists, Rozema, Wolowicz, and Gary Sieger, have decided to do something about that future heart attack before it happens.

Although the men carry influence as condo-association presidents, heretofore they have experienced only mixed success in pleas to state and local officials to keep the clinic in place. They were stood up just last week, for example, by State Rep. Tracy Stafford (D-Wilton Manors), whose district includes the beach. Stafford and Sen. Jim Scott (R-Fort Lauderdale) canceled a long-scheduled meeting with the men only hours before it was to take place. The meeting is rescheduled for May.

The activists want more than that and sooner than May. They want state regulators who determine how many hospital beds should exist in Florida communities to assign more beds to Broward County, and they think their state politicians should encourage the effort. Those beds, island residents hope, would be singled out for use by any hospital that would operate emergency services on the barrier island. Without the assigned beds, state law prohibits an emergency room.

State law also requires EMS personnel to transport victims only to an emergency room. Not to an "urgent care" clinic, a name that inspires a sarcastic belly laugh from Gary Sieger. "One thing they don't do there is urgent care the way you might think of it," he explains. "Don't ever make the mistake of driving somebody there who is in trouble." When representatives from both the Cleveland Clinic and Holy Cross Hospital tried to placate residents by announcing plans to open urgent care clinics on the barrier island, the activists decided to visit an urgent care clinic in Fort Lauderdale. What they discovered did not reassure them. If someone arrives complaining of chest pains, for example, "they call 911 just like anybody else," Hariton reports.

Although the residents want to see another hospital take over the emergency room at the Cleveland Clinic, that probably won't happen. "It's a perfect spot, it's ready to go, but there's too much money in big development," Hariton complains. The likely plan, instead, calls for a 25-story Hyatt "retirement" community with assisted living where the average age of residents would be 78 years old. The building's height alone would exceed the local code by ten stories, a code Hyatt officials say they aren't worried about getting around. "We'll just go to setbacks and variances," says James Bloomquist, a Hyatt vice president who confirmed the plan and announced Hyatt would start building immediately after the hospital's move if the deal goes through. His confidence is based on talks with city officials and negotiations with Cleveland Clinic representatives, he says.

If they face resistance, Hyatt executives have history on their side, too. Since 1995 Fort Lauderdale officials have willingly altered city codes for height, width, setbacks, and population density in favor of beachfront development. In more than ten locations in a two-mile stretch, buildings rise well above the standard code limit of 15 stories. Five years ago city officials also agreed to change the code for density in the big condos, jumping it from 40 units per acre to 60. The 50 percent increase in density gives developers a chance to make a lot more money per acre.

All this has resulted in "monstrosities," including the 28-story L'Hermitage and the Palms, says Hariton. Mayor Jim Naugle echoes the opinion. Naugle voted against allowing the Palms to rise right through the roof of city codes in 1995, when current commissioners Jack Latona and Carlton Moore supported the project. "The Palms thing was greased like lightning; they hired the former city attorney to get the variances," Naugle recalls. "It puts an unfair burden on the community, but there's nothing I can do about it now."

Visible just south of the hospital, a single Palms tower the color of pink bubble gum now rises 31 stories out of the sand, about 400 feet. A second, partially erected building climbs toward 32 stories. The massive project, offering only the most limited setback from the street, presages what may come at the Cleveland Clinic site, according to both Naugle and residents.

The corps of activists, who claim they now have more than 10,000 signatures of concerned residents, have succeeded in gaining the attention of their city commissioners. Both Gloria Katz and Tim Smith, whose commission districts front the beach, have promised to lobby other politicians as well as hospital executives for emergency care on the barrier island. And both say they oppose a Hyatt highrise.

For Smith the antidevelopment position is new, requiring a change of direction. Although he has strongly supported sizable beach-development projects in the past -- the latest is Bridgeside Square, a complex of rental apartments, shops, and a parking garage now rising in Smith's district -- he now claims enough is enough. "We need to push dense development away from that area," he says. "There are plenty of places with open arms waiting for the Hyatt, and I got addresses for them."

But the solution may not be as simple as alternate business addresses, a fact recognized by Hariton. "The Cleveland Clinic is a private business," Hariton acknowledges, "they can do what they want." And if they want to sell to the Hyatt for big bucks and city officials try to put a damper on the deal, city taxpayers could end up footing the bill. According to state law, "if a city limits what an owner can do with their property and others have done it, the owner can get compensated," explains Naugle. Compensated with taxpayer money. So officials might not risk strongly opposing either the Cleveland Clinic's decision to sell or the Hyatt's plan to build, Hariton figures.

None of that makes him or his fellow barrier islanders comfortable. But it inspires their storytelling. "There's another one, the wife of the former U.S. ambassador to Greece," says Ray Wolowicz. "She was sitting in the Black Orchid having dinner one night when she suddenly started bleeding internally. The hospital was right there, and it was lucky. They got her into the emergency room in time, and then into surgery. It saved her life."

The graying heads of his companions are all nodding. And soon the signed pages of their petitions will be arriving on the desks of politicians.

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